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- Title
Combination of pembrolizumab and chemotherapy as first-line treatment in advanced triple-negative breast cancer: a cost-effectiveness analysis.
- Authors
Wentao Zhu; Wanglong Hong; Miaomiao Zheng; Guoqiang Ma; Aizong Shen
- Abstract
The purpose of this study was to assess the cost-effectiveness of using pembrolizumab plus chemotherapy for advanced triple-negative breast cancer (TNBC) in the context of China's healthcare system. To achieve this, we developed a Markov model with three health states, a time horizon of 10 years, and a cycle length of 21 days. Additionally, we conducted one-way sensitivity analyses and probabilistic sensitivity analyses to test the model's stability. Scenario analyses were also performed to explore the cost-effectiveness of pembrolizumab plus chemotherapy based on the Patient Assistance Program (PAP). The base-case analysis demonstrated that pembrolizumab plus chemotherapy provided an additional 0.67 QALYs, with an incremental cost of $ 77 096.78, resulting in an ICER of $ 115 896.30/QALY. One-way sensitivity analyses revealed that pembrolizumab cost had the greatest impact on the results. In probabilistic sensitivity analyses, pembrolizumab plus chemotherapy was found to be cost-effective in 0% of cases at willingness-to-pay thresholds of $ 33 782.23/QALY. Considering China's healthcare system, pembrolizumab plus chemotherapy as first-line treatment for advanced TNBC was unlikely to be cost-effective when compared to placebo plus chemotherapy. Even if pembrolizumab was to be included in the PAP, it would still not be considered cost-effective, although the ICER would be much closer to three times China's GDP per capita ($ 33 782.23/QALY).
- Subjects
CHINA; TRIPLE-negative breast cancer; COMBINATION drug therapy; COST effectiveness; MARKOV processes; DIRECT costing; ERIBULIN
- Publication
Journal of Chinese Pharmaceutical Sciences, 2023, Vol 32, Issue 7, p587
- ISSN
1003-1057
- Publication type
Article
- DOI
10.5246/jcps.2023.07.049